Practice of informed consent in Guangdong, China: a qualitative study from the perspective of in-hospital patients

Abstract

ObjectiveThis study aimed to investigate the practice of informed consent in China from the perspective of patients.DesignA qualitative study using in-depth interviews with in-hospital patients focusing on personal experience with informed consent.SettingGuangdong Province, China.Participants71 in-hospital patients in rehabilitation after surgical operations were included.ResultsMedical information is not actively conveyed by doctors nor effectively received by patients. Without complete and understandable information, patients are unable to make an autonomous clinical decision but must sign an informed consent form following the doctor’s medical arrangement. Three barriers to accessing medical information by patients were identified: (1) medical information received by patients was insufficient to support their decision-making, (2) patients lacked medical knowledge to understand the perceptions of doctors and (3) patient–doctor interactions were insufficient in clinical settings.ConclusionsInformed consent is implemented as an administrative procedure at the hospital level in China. However, it has not been embedded in doctors’ clinical practices because, from the perspective of patients, doctors do not fulfil the obligation of medical information provision. As a result, the informed part of informed consent was neglected by individual doctors in China. Reforming medical education, monitoring the process of informed consent in clinical settings and redesigning medical institutional arrangements are pathways to restoring the practice of informed consent and patient-centred models in China.

Exploring the Delay in the Informed Consent Procedures of Patients with ST-Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention: Is It Worth the Wait?

“…To improve the informed consent procedure, it is advisable to give more weight to humanistic training in medical education, such as communication skills and professionalism. 12 Moreover, the results suggested that sustainable chest pain, intermittent chat pain and dyspnea were signi cantly related to informed consent delay, which contributed to an increase in delay times. As they are non-typical symptoms of STEMI that seem not to critically endanger the patients, they might be considered less risky.…”

“…According to laws and regulations, clinicians have to obtain patients' or relatives' consent before performing any surgery, regardless of the severity and urgency of the disease. 11,12 Even though reducing in-hospital delay is of the essence, given patients' disease severity, patients' education level, the need to have a discussion with their family, it is de nitely appropriate to take time to get consent from patients. 13,14 Different from a usual medical treatment, a decision must be made urgently in emergency care to improve the effect of medical treatment for the patients who is in a critical situation.…”

“…Same regulation also could be found in other countries, such as the United Kingdom. 15 However, Chinese practitioners have the right of emergency treatment, 12 but there are no clear instructions on under what circumstance it could be exerted. They commonly do not start the surgical procedure unless the patients or their relatives reach an agreement.…”

Monitoring Analysis of Filling The Informed Consent of Blood Transfusion

“…5 Informed consent is also very much needed by patients because patients have the right in their medical information and actions to be taken against them so that it will support decision-making and can build a trusting relationship, this is in line with research conducted by Gong N. In Gong N's research, states that from the patient's point of view, informed consent that is not conveyed to them is an obstacle to decision making for actions to be carried out on them. 6 In the research, N. Bowers revealed that a very good and regular explanation during the informed consent process can increase the patient's understanding of the procedure to be performed so that it will be beneficial to the patient and the procedure carried out will run well. 7 Re-education on informed consent and form filling informed consent was implemented on December 10, 2020, through internet meeting, which was attended by 37 participants, and running smoothly.…”

medAR: An augmented reality application to improve participation in health‐care decisions by family‐based intervention

“…Secondly, we equally know that doctors do not fulfil the obligation of medical information provision from the perspective of Chinese patients. 3 We manage to change information asymmetry between doctor and patient or family member. Several studies have shown that augmented reality (AR) can assist shared decision making (SDM) 4,5 : AR can support doctors' explanations with a live simulation that presents all the involved clinical processes.…”